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Javascript is currently disabled in your browser. Several features of this site will not function ,m javascript is disabled. Received 17 May Published 15 December Volume Pages 19— Review by Single-blind. Editor who approved publication: Professor Igal Wolman. Methods: A cohort study was performed from March to April The 2, first trimester pregnancy ultrasounds were examined.

Eight sonographers, according to previous ultrasound experience, were divided into two groups: senior and junior. For fetal sex estimation, sex method of a sagittal section and the relation between the angle formed by the genital tubercle and spinal column was used. Results: In 1, cases, fetal sex was diagnosed, with a success rate of The rate of success in male fetuses was significantly higher than in female fetuses In the senior sonographers group, the rate of overall success was Both CRL and fetal sex influence the rate of success; however, the experience of a sonographer has not proven to be an influential factor.

These results could be explained because the technique for diagnosing sex during the first trimester is very simple to learn. Keywords: fetal sex, first trimester, sex, prenatal diagnosis. Improvements in ultrasound systems have allowed over sex last few years to see the fetal morphology more clearly, and to detect fetal sex earlier during the first trimester, jm for increasing embryo size, and for male fetuses.

At the beginning of the 5th week of pregnancy, a pair of swelling or cloacal folds form on both sides of the cloacal membrane, which joins in front of the membrane to form a thickening in the midline called the genital tubercle primordium penis or clitoris.

During the 9th week, they begin to differentiate, but the similar appearance of the external genitalia in embryos of both sexes may persist until the 9th week of development. Until now, published literature brings inconsistent data regarding the rate of success in the diagnosis of fetal sex during the first trimester, although most sex the articles agree that it depends on sex length CRL and fetal sex. Various methodologies have been reported to describe the fetal sex during the first trimester.

In mj fetuses, however, only two echogenic lines corresponding to the clitoris are identified. This technique has an accuracy of This method achieved an overall accuracy of The aim of this study was to determine the probability of correctly diagnosing fetal sex during the first trimester according to CRL and the sonographers previous ultrasound experience. A cohort study was performed with prospective follow-up of pregnant women attending the Prenatal Diagnosis Unit to perform an ultrasound study for obtaining combined first trimester screening during the period from March to April Oral informed consent was obtained from all patients.

Each pregnant woman was evaluated by one of eight sonographers who applied the correct algorithm to ,m fetal sex. Inclusion criteria for patients were singleton pregnancy, a viable fetus without congenital anomalies, and CRL between 45 and 80 mm.

The exclusion criteria included patient refusal to continue the study, attended birth at another hospital and the diagnosis of fetal death, congenital anomaly, or inability to confirm fetal sex at birth.

An initial assessment of the type of gestation, vitality, embryo morphology, and possibility to describe the fetal sex without telling the patient was performed. It is very important that the fetus is visualized in the neutral position, otherwise the angle may be overestimated or underestimated and the result may be misleading. Figure 2 Female mmm ultrasound identification of the female fetal sex at first trimester ultrasound scan shows the genital tubercle parallel to the spinal column.

Note: Inset shows full ultrasound scan. The outcome variable was described by ultrasound fetal sex. Sex second outcome variable is secondary to obtaining ses or wrongness true or false as matching or not sex described srx first trimester ultrasound and sex at birth. The collection of variables was performed in two stages, recruitment coinciding with the ultrasound examination during sed first trimester and post-delivery.

Perinatal data were obtained for eight sex blinded mn the results of the variables display during the first trimester ultrasound. Records of newborns were created to collect perinatal data. All data were collected in coded form and were entered into a database designed for this purpose. The statistical package used was SPSS To describe the characteristics of the pregnant women included in the study, predictor and outcome variables were evaluated descriptively.

Qualitative variables are detailed as a percentage. To check the fit to normal of each of the variables analyzed in this study, the Kolmogorov—Smirnov test was used. Chi-square and logistic regression according to variable types using bivariate and multivariate analysis were used. Between March and April2, first trimester pregnancy ultrasounds were examined. A total of patients who aborted after the first trimester ultrasound or the patients who gave birth at another hospital were not included in the sample The average age of pregnant women was Mean days to delivery adjusted CRL was — days.

In cases The outcome was confirmed at delivery without encountering any case of ambiguous genitalia. In 1, cases Analyzing the rate of success in the diagnosis of fetal sex, it was found that fetuses were significantly higher in males than in females Figure 3 Success rate according to fetal sex algorithm. Abbreviation: CRL, crown—rump length. Analyzing the association between the rate of success in the diagnosis of fetal sex and the CRL, it was noted that in zex fetuses compared with female fetuses, the rate of success is higher for short CRL.

Figure 4 Global success rate according to CRL and divided by sex. The average rate of success in the sex sex diagnosis for all cases mj The total number of cases was 2. However, in the senior sonographers group, the rate of overall success was Finally, Table 1 describes the results of univariate and multivariate analysis of independent variables and its relation to the success rate in the diagnosis of fetal sex.

Consistently, both the CRL with an odds ratio of 1. Table 1 Results of univariate and multivariate analysis of independent variables and its relation to the success rate in the diagnosis of fetal sex Abbreviations: CI, confidence interval; CRL, crown—rump sex OR, odds ratio. Factors that have been analyzed are the experience of the sonographer and fetal CRL determining the accuracy of the estimation of fetal sed using the method of a sagittal section and the relation between the angle formed by the genital tubercle and spinal column.

Whitlow et al combined fetal sex identification in a sagittal and transverse plane with an accuracy that increases with increasing gestational age.

In our study, the rate of success in fetal sex diagnosis following the methodology described by Chelli et al sex This rate was significantly associated with the CRL, and it increases in male fetuses.

The rate of success was higher in male fetuses than in female ones, Adiego Burgos et al also had similar results with a success rate in male fetuses of Regarding the size of the fetus, according to the CRL, it is clear that there is esx direct sex between diagnostic accuracy and CRL regardless of fetal sex. No significant differences in the rate of success of fetal sex diagnosis depending on the experience of the sonographer were found.

Finally, in the multivariate analysis, these data are consistent and the experience of the sonographer does not influence the probability of success. There have been no previous studies on whether learning technique or the experience of the sonographer influences the rate of success of fetal sex determination. Our results show with the largest sample studied to date that 1-week training is enough to make a correct diagnosis, thanks to the good visualization of equipment, the simplicity of viewing genital tubercles and usually the fetus being placed on the back.

Of the three variables that have been analyzed, it was found that CRL and fetal sex do influence the rate of success; however, the experience of the sonographer has not been shown to be an influential factor.

Therefore, knowing the methodology, with a short learning curve and ultrasound equipment available today, we have ses simple and practical tool to establish fetal sex during the first trimester with great reliability.

Reduction in diagnostic and therapeutic interventions by non-invasive determination of fetal sex in early pregnancy. Prenat Diagn. Ultrasound evaluation of fetal gender at 12—14 weeks. The sagittal sign. An early second trimester sonographic indicator of fetal gender. J Ultrasound Med.

Early determination of fetal sex using transvaginal ultrasonography: technique and pitfalls. J Clin Ultrasound. Pedreira DAL. Ultrasound Obstet Gynecol. Fetal gender assignment by first trimester ultrasound.

The sonographic identification of fetal gender from 11 to 14 weeks of gestation. Acta Obstet Gynecol Scand. Fetal sex assignment by first trimester ultrasound: a Tunisian experience.

Rev Chil Obstet Ginecol. Sonographic early fetal gender assignment: a longitudinal study in pregnancies after in vitro fertilization. Benoit B. Early fetal gender determination. This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, dex see paragraphs ,m.

In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content.

In 1, cases Analyzing the rate of success in the diagnosis of fetal sex, it was found that fetuses were significantly higher in males than in females Figure 3 Success rate according to fetal sex algorithm. Abbreviation: CRL, crown—rump length. Analyzing the association between the rate of success in the diagnosis of fetal sex and the CRL, it was noted that in male fetuses compared with female fetuses, the rate of success is higher for short CRL. Figure 4 Global success rate according to CRL and divided by sex.

The average rate of success in the fetal sex diagnosis for all cases was The total number of cases was 2. However, in the senior sonographers group, the rate of overall success was Finally, Table 1 describes the results of univariate and multivariate analysis of independent variables and its relation to the success rate in the diagnosis of fetal sex.

Consistently, both the CRL with an odds ratio of 1. Table 1 Results of univariate and multivariate analysis of independent variables and its relation to the success rate in the diagnosis of fetal sex Abbreviations: CI, confidence interval; CRL, crown—rump length; OR, odds ratio. Factors that have been analyzed are the experience of the sonographer and fetal CRL determining the accuracy of the estimation of fetal sex using the method of a sagittal section and the relation between the angle formed by the genital tubercle and spinal column.

Whitlow et al combined fetal sex identification in a sagittal and transverse plane with an accuracy that increases with increasing gestational age. In our study, the rate of success in fetal sex diagnosis following the methodology described by Chelli et al was This rate was significantly associated with the CRL, and it increases in male fetuses.

The rate of success was higher in male fetuses than in female ones, Adiego Burgos et al also had similar results with a success rate in male fetuses of Regarding the size of the fetus, according to the CRL, it is clear that there is a direct correlation between diagnostic accuracy and CRL regardless of fetal sex. No significant differences in the rate of success of fetal sex diagnosis depending on the experience of the sonographer were found.

Finally, in the multivariate analysis, these data are consistent and the experience of the sonographer does not influence the probability of success. There have been no previous studies on whether learning technique or the experience of the sonographer influences the rate of success of fetal sex determination.

Our results show with the largest sample studied to date that 1-week training is enough to make a correct diagnosis, thanks to the good visualization of equipment, the simplicity of viewing genital tubercles and usually the fetus being placed on the back.

Of the three variables that have been analyzed, it was found that CRL and fetal sex do influence the rate of success; however, the experience of the sonographer has not been shown to be an influential factor. Therefore, knowing the methodology, with a short learning curve and ultrasound equipment available today, we have a simple and practical tool to establish fetal sex during the first trimester with great reliability.

Reduction in diagnostic and therapeutic interventions by non-invasive determination of fetal sex in early pregnancy. Prenat Diagn. Ultrasound evaluation of fetal gender at 12—14 weeks. The sagittal sign. An early second trimester sonographic indicator of fetal gender. J Ultrasound Med. Early determination of fetal sex using transvaginal ultrasonography: technique and pitfalls. J Clin Ultrasound. Pedreira DAL. Ultrasound Obstet Gynecol. Fetal gender assignment by first trimester ultrasound. The sonographic identification of fetal gender from 11 to 14 weeks of gestation.

Acta Obstet Gynecol Scand. Fetal sex assignment by first trimester ultrasound: a Tunisian experience. Rev Chil Obstet Ginecol. Sonographic early fetal gender assignment: a longitudinal study in pregnancies after in vitro fertilization.

Benoit B. Early fetal gender determination. This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

For permission for commercial use of this work, please see paragraphs 4. In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. You can learn about our use of cookies by reading our Privacy Policy. We also retain data in relation to our visitors and registered users for internal purposes and for sharing information with our business partners.

You can learn about what data of yours we retain, how it is processed, who it is shared with and your right to have your data deleted by reading our Privacy Policy. Journals Why Publish With Us? Advanced search. Home Journals Why publish with us? Abstract Fulltext Metrics Get Permission. Demographic characteristics included age, sex, race, and ethnicity. The benchmark risk for age to initiate screening was based on white men, years old.

Women had lower risks than men in every age group, regardless of race. Blacks had higher risk than whites from ages 50 through 65 years and Hispanics had lower risk than whites from ages 50 through 80 years.

The prevalence of large polyps was 6. The risk was similar among the groups of white women years old, black women years old, black men years old, Hispanic women years old, and Hispanic men years old.

The risk of proximal large polyps increased with age, female sex, and black race.